Nutrition Therapy
Sodium restriction is recommended in all patients with HF. Despite the theoretical basis for limiting sodium intake, the American Heart Association acknowledge that the recommendation to limit sodium is based on expert consensus only, not empirical evidence.
In fact, two randomized trials suggest that a normal sodium intake, combined with appropriate medication and fluid restriction, could restore intravascular volume and renal blood flow and facilitate renal excretion of sodium and water. In both studies, patients consuming the higher amounts of sodium had better outcomes (fewer readmission and improved creatinine clearance, respectively) than participants consuming a low-sodium diet (e.g.;1800 mg). Conversely, Arcand et al.(2011) showed that ambulatory HF patients who consume higher amounts of sodium are at greater risk of acute decompensated HF exacerbation. Although the optimail